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Diffusion tensor imaging in unclear intramedullary tumor-suspected lesions allows separating tumors from inflammation

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Název: Diffusion tensor imaging in unclear intramedullary tumor-suspected lesions allows separating tumors from inflammation
Autoři: Marc Hohenhaus, Yorn Merz, Jan-Helge Klingler, Christoph Scholz, Ulrich Hubbe, Jürgen Beck, Katharina Wolf, Karl Egger, Marco Reisert, Nico Kremers
Zdroj: Spinal Cord
Informace o vydavateli: Springer Science and Business Media LLC, 2021.
Rok vydání: 2021
Témata: Inflammation, Spinal Cord Neoplasms/pathology [MeSH], Spinal Cord/pathology [MeSH], Humans [MeSH], Prospective Studies [MeSH], Cancer imaging, Diffusion Tensor Imaging/methods [MeSH], Ependymoma/pathology [MeSH], Article, Spinal Cord Neoplasms/diagnostic imaging [MeSH], Inflammation/diagnostic imaging [MeSH], Ependymoma/diagnostic imaging [MeSH], Inflammation/pathology [MeSH], Spinal Cord Diseases [MeSH], Spinal Cord Injuries/pathology [MeSH], Spinal cord diseases, Spine structure, Spinal Cord Diseases, 3. Good health, 03 medical and health sciences, Diffusion Tensor Imaging, 0302 clinical medicine, Spinal Cord, Ependymoma, Humans, Prospective Studies, Spinal Cord Neoplasms, Spinal Cord Injuries
Popis: Design Prospective diagnostic study. Objectives Primary imaging-based diagnosis of spinal cord tumor-suspected lesions is often challenging. The identification of the definite entity is crucial for dedicated treatment and therefore reduction of morbidity. The aim of this trial was to investigate specific quantitative signal patterns to differentiate unclear intramedullary tumor-suspected lesions based on diffusion tensor imaging (DTI). Setting Medical Center - University of Freiburg, Germany. Methods Forty patients with an unclear tumor-suspected lesion of the spinal cord prospectively underwent DTI. Primary diagnosis was determined by histological or clinical work-up or remained indeterminate with follow-up. DTI metrics (FA/ADC) were evaluated at the central lesion area, lesion margin, edema, and normal spinal cord and compared between different diagnostic groups (ependymomas, other spinal cord tumors, inflammations). Results Mean DTI metrics for all spinal cord tumors (n = 18) showed significantly reduced FA and increased ADC values compared to inflammatory lesions (n = 8) at the lesion margin (p p = 0.001) and reduced FA at the central lesion area (p n = 10) and other spinal cord tumors (n = 8), but remaining differences for both compared to the inflammation subgroup. We found significant higher ADC (p = 0.040) and a trend to decreased FA (p = 0.081) for ependymomas compared to inflammations at the edema. Conclusion Even if distinct differentiation of ependymomas from other spinal cord neoplasms was not possible based on quantitative DTI metrics, FA and ADC were feasible to separate inflammatory lesions. This may avoid unnecessary surgery in patients with unclear intramedullary tumor-suspected lesions.
Druh dokumentu: Article
Other literature type
Popis souboru: pdf
Jazyk: English
ISSN: 1476-5624
1362-4393
DOI: 10.1038/s41393-021-00741-2
Přístupová URL adresa: https://www.nature.com/articles/s41393-021-00741-2.pdf
https://pubmed.ncbi.nlm.nih.gov/34966172
https://repository.publisso.de/resource/frl:6442928
Rights: CC BY
URL: http://creativecommons.org/licenses/by/4.0/Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The images or other third party material in this article are included in the article’s Creative Commons license, unless indicated otherwise in a credit line to the material. If material is not included in the article’s Creative Commons license and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this license, visit http://creativecommons.org/licenses/by/4.0/ (http://creativecommons.org/licenses/by/4.0/) .
Přístupové číslo: edsair.doi.dedup.....25ba733582df82df4bc508dd19fa75d4
Databáze: OpenAIRE
Popis
Abstrakt:Design Prospective diagnostic study. Objectives Primary imaging-based diagnosis of spinal cord tumor-suspected lesions is often challenging. The identification of the definite entity is crucial for dedicated treatment and therefore reduction of morbidity. The aim of this trial was to investigate specific quantitative signal patterns to differentiate unclear intramedullary tumor-suspected lesions based on diffusion tensor imaging (DTI). Setting Medical Center - University of Freiburg, Germany. Methods Forty patients with an unclear tumor-suspected lesion of the spinal cord prospectively underwent DTI. Primary diagnosis was determined by histological or clinical work-up or remained indeterminate with follow-up. DTI metrics (FA/ADC) were evaluated at the central lesion area, lesion margin, edema, and normal spinal cord and compared between different diagnostic groups (ependymomas, other spinal cord tumors, inflammations). Results Mean DTI metrics for all spinal cord tumors (n = 18) showed significantly reduced FA and increased ADC values compared to inflammatory lesions (n = 8) at the lesion margin (p p = 0.001) and reduced FA at the central lesion area (p n = 10) and other spinal cord tumors (n = 8), but remaining differences for both compared to the inflammation subgroup. We found significant higher ADC (p = 0.040) and a trend to decreased FA (p = 0.081) for ependymomas compared to inflammations at the edema. Conclusion Even if distinct differentiation of ependymomas from other spinal cord neoplasms was not possible based on quantitative DTI metrics, FA and ADC were feasible to separate inflammatory lesions. This may avoid unnecessary surgery in patients with unclear intramedullary tumor-suspected lesions.
ISSN:14765624
13624393
DOI:10.1038/s41393-021-00741-2